Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)
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Hypereosinophilic syndrome is characterized by peripheral eosinophilia over 1,500 cell/mm3 and/or tissue eosinophilia, with dysfunction or damage to organ, once other causes were ruled out. This paper presents a case of hypereosinophilic syndrome (HS) which presented as lymphoblastic leukemia in a teenager. This is a 13 year old female, with B cell lymphoblastic leukemia at 9 years old, who received chemotherapy for 2 years achieving remission. ⋯ Six months after the onset of symptomatology there were generalized malaise, uncontrolled fever, gingival haemorrhage, asthenia and adynamia; a blood cell count reported blasts, and bone marrow smear confirmed the diagnosis of cell B lymphoblastic leukemia. The patient deteriorated rapidly showing signs of respiratory difficulty and acute pulmonary edema, therefore chemotherapy was started without response, and finally the patient died. There are several causes of HS, yet one of the least frequent presentations in childhood is the association with neoplasms.
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Observational Study
[Association between Helicobacter pylori and allergic and non-allergic chronic urticaria].
Chronic urticaria is characterized by swelling and itchy hives presenting remissions and exacerbations, for six weeks or more, which may or may not be accompanied by angioedema. Helicobacter pylori infection has been associated with various diseases among them chronic urticaria. ⋯ We found no association between chronic allergic urticaria and H. pylori infection.
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The incidence of severe intraoperative anesthetic reactions varies among countries from 1:10,000 to 1:13 000 patients submitted to surgery. ⋯ A 13 year old male, with family history of atopy, who underwent 5 surgeries for hydrocephalus, using general anesthesia. He was on lamotrigine for seizures. He also suffers from chronic rhinitis, and oral allergy syndrome related to bananas since the age of 6 months. He had a posterior fossa tumor resection. During anesthesia induction with atracurium he developed a local rash in one arm, being the intubation without difficulty. Twenty minutes later he presented bipalpebral edema, accompanied by generalized rash, severe bronchoconstriction and hypotension, not reversing with the use of bronchodilators and corticosteroids. With the use of antihistamines, epinephrine and controlled ventilation the reaction subsides. One month later a skin prick test with atracurium besylate (50 mg/mL) diluted 1:10,000, negative and positive controls was performed. The result with atracurium was negative. After the application of intradermal tests with 0.02 mL of atracurium at dilutions of 1:10,000 and 1:1000, we found a positive skin response to atracurium (wheal diameter >8 mm and >9 mm with dilutions 1:10,000 and 1:1000, respectively and erythema). The response to atracurium intradermal test could be related to the ability of histamine release by a nonimmunological mechanism. But the magnitude of the skin response in this case, do not rule out the possibility of an IgE-mediated reaction. Atracurium is a known potent histamine releaser from mast cells, but rarely can it cause IgE-mediated reactions.
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Multicenter Study Comparative Study
[Anesthesiologist's aptitude for peri-operative detection and treatment of latex allergy].
Latex allergy is the second cause of perioperative anaphylaxis. Anesthesiologists play a key role in opportune identification of risk factors, as well as clinical diagnosis and therapeutic management. ⋯ A suboptimal aptitude was identified among anesthesiologists regarding identification of latex allergy. A need to establish new strategies for educative intervention in order to improve this issue was identified.